Dutch study finds pediatricians more apt to diagnose the condition than general practitioners

FRIDAY, April 22 (HealthDay News) -- Chronic fatigue syndrome, often thought to be a condition that only afflicts adults, affects adolescents as well but is often overlooked, according to a new Dutch report in Pediatrics.

Though the syndrome is much less common among teens than adults, it often goes undiagnosed, especially by general practice doctors, according to Dr. S.L. Nijhof, co-author of the report and a physician at Wilhelmina Children's Hospital at the University Medical Center in Utrecht.

Nijhof isn't referring to the tiredness typical of growing, busy teens. "Fatigue is a common complaint among adolescents, with a good prognosis," Nijhof said. "Chronic fatigue syndrome is much less common, but with serious consequences."

Nijhof and fellow researchers collected data from 354 general practitioners in the Netherlands who responded to a national survey focusing on new patients diagnosed with chronic fatigue syndrome, including the prevalence of the condition among their patients, meaning the number of cases at any given time. They also gathered information from a registry that recorded new diagnoses of teen chronic fatigue patients at pediatric hospitals, including the number of new cases a year, or incidence of the condition.

They found that about 1 in 900 teens developed chronic fatigue, which was much lower than in the adult population. The prevalence was 111 per 100,000 teens, and the annual incidence was 12 per 100,000.

However, nearly 75 percent of the teens were not diagnosed by their general practitioner but by a pediatrician or other health-care provider, the study reported.

Of the participating general practitioners, just half said they accepted chronic fatigue syndrome as a distinct diagnosis in their teen patients. By contrast, 96 percent of the doctors from the pediatric departments consulted said they did.

"We want to create awareness among [general practitioners] and support the idea that adolescents with severe fatigue should be referred to a pediatrician," Nijhof said. "Chronic fatigue is much less common [in teens], but with serious consequences."

The survey revealed that 90 percent of teens with the condition had considerable school absences, defined as missing school at least 15 percent of the time.

Dr. Nancy Klimas, director of the Chronic Fatigue Center at the University of Miami Miller School of Medicine, who treats teens with the condition, said that the study findings ring true.

Parents should be aware, first of all, that the condition can strike teens, she said. "Very frequently it happens after a mononucleosis infection," she said, adding that teens very often return to school and to activities too soon, and that can be linked to triggering chronic fatigue.

Among symptoms of the condition, Klimas said, are pain in muscles and joints, a sore throat and swollen lymph nodes. A teen might wake up still exhausted after a night's sleep. The teen might also have memory or concentration problems, as well as headaches.

And if a teen athlete with the condition returns to sports too quickly, he or she might feel lousy the next day -- something that Klimas called "exercise-induced relapse." That's also a signal to see a pediatrician, she said.